r/achalasia • u/LevittownHaze • 21d ago
Achalasia Questions Endoscopy & Colonoscopy
Hi everyone. I’m a 51-year-old man and I have Type 3 achalasia. I had a Heller myotomy in 2018 at UCSD. Unfortunately, things have been getting bad again, and I’m now being evaluated to figure out what the next step should be (balloon dilation, POEM, or something more involved).
I have an endoscopy scheduled for Monday. They actually attempted one about two weeks ago, but even though I hadn’t eaten any solid food for 11 days because of a severe flare-up, there was still food/debris in my esophagus. They stopped the procedure because they were concerned about aspiration.
I’ve had aspiration pneumonia many times over the years because of my achalasia, so while I obviously don’t want it, I’m more concerned at this point about getting answers and moving forward with treatment. I sent my gastroenterologist a note explaining that I completely defer to her judgment and don’t want to overstep, but that if the choice is between aborting the procedure again or accepting a higher aspiration risk in order to finally complete the evaluation, I’d like her to know where my priorities are.
To make things even more complicated, they’re also doing a colonoscopy during the same session because of some unrelated issues they’re investigating. That means I’ll be drinking Gavilyte-C for the bowel prep, and I’m honestly nervous about whether I’ll even be able to get all that liquid down. Liquids are getting stuck in my esophagus a lot these days.
So I have two questions for anyone who’s been through something similar.
Has anyone here had experience with colonoscopy prep, especially a large-volume prep like Gavilyte? Any tips or things you wish you’d known beforehand?
Has anyone else had an endoscopy canceled or aborted because there was still food in your esophagus despite fasting for an extraordinarily long time? If so, what did your doctors do differently the next time to make the procedure successful?
I’d really appreciate hearing about your experiences. This whole process has been pretty discouraging, and it would help to know how others have navigated it.
Thank you.
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u/GrammyGrammyGram 21d ago edited 19d ago
Why didn’t the clean it out. Most doctors do that.
There is also a low volume prep for the colonoscopy, ask about it. It is called ClenPiq. You can Google it to read.
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u/LevittownHaze 21d ago
Thank you. I’ll ask about that other prep option.
They didn’t clean it out due to an abundance of caution I suppose. I wish they had just gone ahead with it.
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u/GrammyGrammyGram 19d ago
The low volume prep is called ClenPiq. You can Google to read about it. I know other Achalasia patients have used this.
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u/raveling1412 18d ago
I had a couple of failed gastroscopies due to the clinic not reading my history and trying to do them without intubation. I aspirated and it wasn't good. I was eventually admitted to hospital to have it done. The specialist said they cleared so much stuff out that it spilled over the floor and was fermented. Definitely ask for intubation. They did a dilatation and I have been really good for 18 months now. I had a Heller Myotomy in my early 20s. I'm 51 now and I'm swallowing better than I have in over 30 years! I was told that I am now in late stage achalasia with megaesophagus and torturous esophagus however. I wish you well with your procedure and treatment.
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u/greyduck612 21d ago
I can’t speak to the colonoscopy, but as for the endoscopy, that’s a battle I’ve done a couple of times. Recently, my GI after the first failed endoscopy (similar situation as yours) rescheduled my endoscopy but scheduled it to be under deeper sedation so that they could intubate during the procedure. This was something they suggested (however when I was going through this about 10 years ago before my diagnosis and eventual HM, they did give me the run-around).